Decisions regarding investments in disease management and other similar programs are often hindered by the lack of evidence surrounding the impact of such efforts on policy relevant outcomes. One such void in knowledge is the impact of such programs on labor market outcomes. We propose to conduct a longitudinal study to examine the impact of diabetes control (glycemic, lipid, and blood pressure control) on labor market outcomes. Labor market outcomes include work disability, workforce participation, and work productivity. Using comprehensive automated data systems (medical records, administrative, laboratory, and pharmacy data) available within a large multi-specialty nonprofit integrated health care delivery system in southeast Michigan, we will identify a cohort of employed health plan members with diabetes. These individuals will be interviewed at baseline and annually thereafter for three years. By using a 3-year prospective cohort design and linking interview data with automated laboratory test results, we will be able to explore the relationships between readily available clinical measures of diabetes control and labor market outcomes. Our research aims are: 1) Evaluate the cross-sectional relationship between risk factor (i.e., glycemic, lipid, and blood pressure) levels and work productivity (defined broadly to include average weekly hours worked, work-loss days (absenteeism), health-related work limitations, and productivity while at work (presenteeism) at baseline.; 2) Investigate the longitudinal association between baseline risk factor levels and changes in labor force participation, and changes in work productivity; 3) Estimate the effect of changes in risk factor levels on changes in labor force participation and changes in work productivity. By quantifying the effect of changes in blood glucose, cholesterol, and blood pressure on changes in labor market outcomes, this study will inform patients, families, employers, and decision makers about the labor economic impact of successful diabetes management. The results of this research will not only inform societal perspective evaluations of the cost-effectiveness of diabetes management programs, but also inform employers of the potential return on investment (ROI) from sponsoring such programs.